Title

Authors

Document Type

Presentation

Publication Date

6-27-2013

Comments

Capstone Chair: Harsh Sule, MD, MPP

Capstone Preceptor: Nancy L. Chernett, MA, MPH

Abstract

Out-of-hospitalemergency care is in an early stage of development in Armenia. While efforts are underway by the Ministry of Health (MOH) and other organizations to reform the emergency medical services (EMS) system, little data exists on the status of pediatric emergency care (PEC).To evaluate the knowledge and attitudes of out-of-hospital emergency physicians (EPs) in pediatric rapid assessment and resuscitation, and to identify areas of improvement to the pediatric EMS system and PEC education in the capital, Yerevan, a cross-sectional, anonymous, self-administered Knowledge and Attitudes survey regarding pediatric rapid assessment and resuscitation was distributed to all out-of-hospital EPs in Yerevan from August to September 2012.The response rate was 80%. The majority (89.7%) failed the 10-question knowledge test (pre-defined passing score of ≥7) with a mean score of 4.17 ± 1.99 SD. Answers regarding the relationship between pediatric cardiac arrest and respiratory issues, the compression ventilation ratio in neonates, the definition of hypotension, and recognition of shock were most frequently incorrect. None of the participants had attended pediatric specific continuing medical education (CME) in the last 5 years. Chi-square analysis demonstrated no statistically significant association between: age, length of experience (years working in brigade, type of brigade (general vs cardiac/resuscitation), general CME attendance (yes/no) and pass or fail status.Themajority of participants (98%) agreed that PEC education needs improvement in Armenia, that there is a need for pediatric-specific CME (98%), that national out-of-hospital PEC guidelines would make PEC safer, more efficient and effective (96%).Out-of-hospital emergency physicians in Yerevan, Armenia lack pediatric-specific assessment and resuscitation knowledge and training. There is a need for additional PEC training and CME within the EMS system in Armenia, along with additional support for existing activities.